Transient ischemic attack in the vertebro-basilar circulation due to a hemodynamically significant variation - kinking of the extracranial section of the left vertebral artery.

We present a case report of a 74-year old female patient with the clinical diagnosis of transient ischemic attack (TIA) in the vertebro-basilar (VB) circulation, in whom we found bilateral variation of the extracranial section of vertebral arteries on ultrasound, on the left side to the extent of kinking. This finding was later confirmed by magnetic resonance angiography (MRA). We discuss the presumed hemodynamic significance of this variation and its etiological relation to the patient's clinical picture. Ultrasound examination of the carotid and vertebro-basilar circulations is an important examination technique contributing to an early detection of possible aetiology of the cerebral circulation disorders (Fig. 7, Ref. 18).